Long-term melatonin use in children: Is it safe?

Swedish researchers found that many children and young adults who are prescribed melatonin are still taking it 3 years later and at larger doses.

Using registry data for an urban area centered around Stockholm, the authors determined that 9980 individuals up to aged 25 years were dispensed melatonin in 2016. Most patients (65%) had a neuropsychiatric diagnosis, and only 20% had a sleep disorder.

Prevalence of dispensed melatonin was 0.2% in preschoolers 5 years and younger, 1.4% in children aged 6 to 12 years, 3.4% in adolescents aged 13 to 17 years, and 1.2% in those aged 18 to 25 years.

Comorbid conditions were common, as was polypharmacy, identified in 4567 individuals (46%), more often females than males. Of those who began taking melatonin in 2016, 50% of male patients and 40% of female patients continued to use it throughout the following 3 years, often at increased doses.

Thoughts from Dr. Farber

I, too, would like to see some long-term studies. But given that sleep difficulties are major problems for children and their families, especially when combined with developmental disabilities such as autism, I continue to use melatonin in high doses if needed for these families. For neurotypical children, however, my go-to remains behavioral interventions.

Reference

Tedroff K, von Euler M, Dahlén E. Melatonin usage in children and young adults, a registry-based cohort study. Eur J Paediatr Neurol. 2022;39(30-34). doi:10.1016/j.ejpn.2022.05.007